New study shows rich, poor have huge mortality gap in US

April 11, 2016 by Peter Dizikes, Massachusetts Institute of Technology
“As you go up in the income distribution, life expectancy continues to increase, at every point in the income distribution,” Michael Stepner says. Credit: Christine Daniloff/MIT

Poverty in the U.S. is often associated with deprivation, in areas including housing, employment, and education. Now a study co-authored by two MIT researchers has shown, in unprecedented geographic detail, another stark reality: Poor people live shorter lives, too.

More precisely, the study shows that in the U.S., the richest 1 percent of men lives 14.6 years longer on average than the poorest 1 percent of men, while among women in those wealth percentiles, the difference is 10.1 years on average.

This eye-opening gap is also growing rapidly: Over roughly the last 15 years, increased by 2.34 years for men and 2.91 years for women who are among the top 5 percent of income earners in America, but by just 0.32 and 0.04 years for men and women in the bottom 5 percent of the income tables.

"When we think about income inequality in the United States, we think that low-income Americans can't afford to purchase the same homes, live in the same neighborhoods, and buy the same goods and services as higher-income Americans," says Michael Stepner, a PhD candidate in MIT's Department of Economics. "But the fact that they can on average expect to have 10 or 15 fewer years of life really demonstrates the level of inequality we've had in the United States."

Stepner and Sarah Abraham, another PhD candidate in MIT's Department of Economics, are among the co-authors of a newly published paper summarizing the study's findings, and have played central roles in a three-year research project establishing the results.

In addition to reporting the size and growth of the income gap, the study finds that the average lifespan varies considerably by region in the U.S. (by as much as 4.5 years), but that the sources of that regional variation are subtle, and, like the aggregate national gap, subject to further investigation.

"The patterns are not exactly what you might expect," says Abraham, noting that in longevity does not seem strongly correlated with factors such as access to health care, environmental issues, , or the job market.

"We don't find those to be as highly correlated with differences in longevity as we find measures of health behavior, such as smoking rates or obesity rates" [to be correlated with lifespan], Abraham observes.

The paper, "The Association between Income and Life Expectancy in the United States, 2001-2014," is being published today by the Journal of the American Medical Association.

The authors are Raj Chetty, a professor of economics at Stanford University; Stepner and Abraham of MIT, who are the second and third authors on the paper; Shelby Lin, an analyst with McKinsey and Company in New York; Benjamin Scuderi, a predoctorate fellow in Harvard University's Economics Department; Augustin Bergeron, a PhD candidate in Harvard University's Economics Department; Nicholas Turner of the Office of Tax Analysis in the U.S. Department of the Treasury; and David Cutler, a professor of economics at Harvard University.

The geography of mortality

The researchers looked at 1.4 billion anonymized income tax filings from the federal government, and combined that with mortality data from the years 2001 through 2014 from the Social Security Administration. This represents the most complete geographic and demographic landscape of mortality in America.

Among other things, the growth of the gap in mortality rates—by nearly three years—struck the researchers as noteworthy. To put it in perspective, they note that federal health officials estimate that curing all forms of cancer would add three years to the .

"That change over the last 15 years is the equivalent of the richest Americans winning the war on cancer," Stepner observes.

At the same time, the researchers are quick to point out that the findings cannot immediately be reduced to simple cause-and-effect explanations. For instance, as social scientists have long observed, it is very hard to say whether having wealth leads to better health—or if health, on aggregate, is a prerequisite for accumulating wealth. Most likely, the two interact in complex ways, something the study cannot resolve.

"It's a descriptive story," Stepner says of the data.

A new puzzle emerging from the study, the authors note, is that differences in lifespan exist along the entire continuum of wealth in the U.S.; it is not as if, say, the top 10 percent of earners cluster around identical average lifespans.

"As you go up in the income distribution, life expectancy continues to increase, at every point," Stepner says.

And then there are the new geographic patterns in the findings. For instance: Eight of the 10 states with the lowest life expectancies for people in the bottom income quartile form a contiguous belt, curving around from Michigan through Ohio, Indiana, Kentucky, Tennessee, Arkansas, Oklahoma, and Kansas.

So while average lifespans for everyone are lower in some Southern states, the poor do not fare worse in those places than they do in other regions.

"The Deep South is the lowest-income area in America, but when we're looking at life expectancy conditional on having a low income, it's not worse to be poor in the Deep South than it is in other areas of America," Stepner says. "It's just that there are far more living in the South."

Future research: Think local

The researchers say that more analysis on the sources of local variation in lifespans could be among the most fruitful research areas stemming from the current paper. The research team is releasing all the data from the study today as well.

Among the municipalities where low-income people have experienced the greatest increases in lifespan from 2001-2014, for example, are Toms River, New Jersey; Birmingham, Alabama; and Richmond, Virginia. Cities with the largest drops in lifespan among the poor are Tampa and Pensacola, Florida; and Knoxville, Tennessee.

"We're not making any normative statements about what policy should be, but there is a wide dispersion of [results] happening in the U.S.," Abraham says. "That might need to be addressed at a more granular level."

Places with the overall longest lifespans for the poor include New York City, with a chart-topping 81.8 years on average, as well as a passel of cities in California. The bottom of that list includes Gary, Indiana (77.4 years on average); Las Vegas; and Oklahoma City.

Among the top earners, people live longest in Salt Lake City (87.8 years on average); Portland, Maine; and Spokane, Washington. The rich have the shortest lives in Las Vegas (84.1 years on average); Gary, Indiana; and Honolulu.

Abraham also observes that the findings could have implications for national policy programs, as well.

"Things like Social Security aren't going to be as redistributive if the richer people are getting paid for 10 more years than the poorer people," she says.

Overall, the researchers say they hope to spark a larger discussion among the research and policy communities.

"We don't have all the answers," Abraham says. "But it's really important to make these statistics widely used so people have an idea of what the magnitude of these problems is, where they might focus their attention, and why this matters."

Explore further: Your income, hometown may be key to your lifespan

More information: Raj Chetty et al. The Association Between Income and Life Expectancy in the United States, 2001-2014, JAMA (). DOI: 10.1001/jama.2016.4226

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aksdad
3 / 5 (8) Apr 11, 2016
"Eight of the 10 states with the lowest life expectancies...form a contiguous belt, curving around from Michigan through Ohio, Indiana, Kentucky, Tennessee, Arkansas, Oklahoma, and Kansas."

Coincidentally, those states also have the highest percentage of smokers.

http://www.cdc.go.../#states

"...there is a wide dispersion of [results] happening in the U.S."

No surprise there. The U.S. is also one of the most ethnically diverse of all the wealthy "Western" nations. There are large differences in life expectancy by race, most of it having to do with health and lifestyle choices.

http://www.busine...y-2014-1

The U.S. is one of the freest countries in the world. Freedom and diversity = large disparity of behaviors and resulting consequences.

https://freedomho...PJ5PyvmJ
aksdad
4.2 / 5 (5) Apr 11, 2016
"Things like Social Security aren't going to be as redistributive if the richer people are getting paid for 10 more years than the poorer people."

Interesting comment. The original intent of the Social Security Act of 1935 wasn't to "redistribute" income. It was intended to buffer Americans somewhat from the economic effects of old age, poverty, unemployment and loss of a spouse and expanded to include disabilities.
Eikka
3 / 5 (2) Apr 12, 2016
The original intent of the Social Security Act of 1935 wasn't to "redistribute" income.


You can't give some if you don't take some.
krundoloss
5 / 5 (1) Apr 12, 2016
There is logic to the idea that wealthier americans live longer lives. They will most likely eat higher quality food, the best supplements and vitamins, and seek health in general. After all, they sought wealth, so it would be natural for them to seek health as well.

Poor people will probably think of their health as an afterthought, since other things may be more important. They will probably have lower quality food and not take supplements. They certainly wont have a personal trainer, or a nutritionist.

All this has a cumulative effect on longevity.
shavera
5 / 5 (7) Apr 12, 2016
It's interesting that aksdad labels poverty as a 'lifestyle choice.' I'm sure when you're poor you have soooo much freedom in what activities you can engage in, what medical treatment you receive, what diet you have the time and energy to prepare.

The only freedom that counts is the freedom that exists after you're not afraid of starving to death or choosing between food and medical care. In that measure, the US is hardly the 'free-est' country in the world.
MR166
1 / 5 (1) Apr 12, 2016
"They will probably have lower quality food and not take supplements."

Don't be fooled and think that they eat lower quality food because they cannot afford better food. Many of the worst food products are also the most expensive. Baked goods, sugar products, cereals and snack foods are expensive killers.
MR166
1 / 5 (2) Apr 12, 2016
I very rarely eat simple carbs but a few weeks ago I "Feasted" on bread and pizza. I ate a lot and it tasted great. Two hours later I was lethargic, depressed and hungry. I never feel this way when I eat high quality carbs like beans and animal fats.
gkam
2 / 5 (4) Apr 12, 2016
It was the same way in France just before the revolution.
Kron
not rated yet Apr 12, 2016
Don't want to be that one guy,... but animal fats are not carbohydrates. They are a good source of saturated fats (used in hormone synthesis, cell membrane production etc.) So, just sayin
MR166
not rated yet Apr 12, 2016
Your body has two sources of energy that it can utilize, fats and carbs. Given a choice it will burn carbs first and then fats to maintain blood sugar levels. Thus if you eat say pizza you will turn the carbs into blood sugar and store the rest as body fat. When your blood sugar level drops you will be hungry in a very short time since it does not want to burn the stored fat. If you get most of your calories from fats and not carbs your body will be trained to burn body fat every time it need to increase blood sugar levels. Blood sugar levels will steady since body fat is available 24/7. Your hunger pains and cravings will be greatly diminished.
Captain Stumpy
3.4 / 5 (5) Apr 12, 2016
Don't be fooled and think that they eat lower quality food because they cannot afford better
@Mr166
considering the typical costs, and the bulk foods that last longer or stretch the $$, then cost plays a huge part in it
you can do more with $10 of pasta than $10 of fresh veggies

preservation comes into play as well... and processed canned foods tend to last longer with far less overhead (refrigeration) than frozen or fresh

quality meats are more expensive

not everyone has the ability/space to "grow their own"

limited income often has limiting choices because you must consider duration and responsibilities
you can't just not pay the car payment or insurance because that is what gets you to work
- can't skip work because that is how you eat
- can't skip eating because that is the only thing keeping you able to work
home?
vicious circle, and choices are also limited by availability and location, which can play a role in cost, etc
MR166
3.4 / 5 (5) Apr 12, 2016
If you substitute beans for pasta the cost difference is not much. Canned vegetables, while not as good as fresh, still are a lot better than simple high glycemic index carbs. Eggs are not any more expensive than breakfast cereals. Pork and chicken can be very affordable if you shop carefully and freeze sale items. The US food pyramid and low fat diets have cost more lives than all the coal plants ever built.

If you eat junk carbs like flour, rice and potatoes AND fats the combination is deadly.
Captain Stumpy
3 / 5 (4) Apr 12, 2016
If you substitute beans for pasta the cost difference is not much
@Mr166
depends on income, availability, area, and number of meals as well as energy output over time
Canned vegetables, while not as good as fresh, still are a lot better than simple high glycemic index carbs
true, but that wasn't the point
most poor folk i know don't eat the "fast, easy" processed meals
Eggs are not any more expensive than breakfast cereals
depends. you can make far more meals out of a $4 bag of cereal than a $4 carton of eggs (rural tends to have them far cheaper, but it's the same thing, really)
Pork and chicken can be very affordable if you shop carefully and freeze sale items
and canned meats are cheaper in the long run because of cost of overhead, but are worse for you due to sodium content & processing
plus there is the whole cost of electricity, not to mention cost of equipment
some don't own a deep-freeze, just a small fridge
2Bcont'd
Captain Stumpy
3.4 / 5 (5) Apr 12, 2016
@mr cont'd
junk carbs like flour, rice and potatoes...deadly
and this is my point exactly
the costs of making meals high in junk carbs like flour, rice and potato's are far, far, far cheaper than the cost of making the equivalent number of filling meals with other stuff!

poor folk require food...
most buy staples that are cheap enough to feed them x amount for a duration

this means potato's, rice, pasta and flour .... you can get a far larger number of meals and larger servings out of those staples than, say, the beans and even meats you can get with higher costs

so they stock up on the staples like that and cut the higher cost stuff, which means they can eat more for longer periods and not feel the hunger, which helps them work, which helps them keep a roof, car, etc...

this is a major point people with $$ forget

consider: some don't make enough $ to even be taxed by the gov't in the US
could you live on the same amount?
how would you spend it to live?
MR166
2.3 / 5 (3) Apr 12, 2016
"junk carbs like flour, rice and potatoes...deadly"

Hey Capt. it was a short sentence, why did you not quote the whole thing?

Was there something that you disagreed with in it?
MR166
1 / 5 (2) Apr 12, 2016
Most of the US poor are over-carbed and under-nourished. Because of this diabetes is rampant. Much of this is the direct fault of the US government and their nutritional standards. Falsified studies KILL.
MR166
not rated yet Apr 12, 2016
The studies that linked fats to weight gain and heart attacks were seriously flawed. So flawed in fact that they had to attribute the high fat diet French longevity to red wine.
Captain Stumpy
3.4 / 5 (5) Apr 12, 2016
Hey Capt. it was a short sentence, why did you not quote the whole thing?
Was there something that you disagreed with in it?
@Mr
nope. in fact, i totally agree with it. blame the 1000char limit
thought that was evident?
Most of the US poor are over-carbed and under-nourished. Because of this diabetes is rampant
likely because of the reasons i stated above, not so much because of conspiracy

and it is also not proof of conspiracy to make a claim about the studies when you're talking about a highly complex system that can differ by orders of magnitude between people... for instance: vicodin puts a lot of people to sleep with it's potency. makes them tired. it doesn't affect me at all. not a bit. no tired, no sleepy, barely anything in pain reduction... so it isn't the fault of the stat's or science (because it "usually" does something)... it's a difference in me
Captain Stumpy
3 / 5 (4) Apr 12, 2016
The studies that linked fats to weight gain and heart attacks were seriously flawed
@Mr
if you're going to make this claim, please show the evidence
thanks

first off... generalities for humans are problematic, especially considering the complexity of the human body and it's microbiome, etc

so any generalities in any study will be likely wrong when applied as anything other than a generality

second: there are demonstrated instances of small factors being important in diet or with the human body in general... like the high fat diet of the French... Amish diets... Greek Diets... Italian Diets...

perhaps it's because the human is highly complex and we don't know everything we need to know yet?

anyway... being poor is a huge factor in what one can afford to buy to live yet another month
that is why they make the choices i stated above
is it healthy?
not really
but it feeds the family for the month...
MR166
4 / 5 (1) Apr 12, 2016
Capt. In general the peoples who eat high carb starchy diets have little access to animal fats and survive, IE the Chinese. Others like the Eskimos have a high fat low carb diet and also do very well. Combine the 2, like in the US, and you get diabetes and heart attacks. Also, most people in the less developed countries do not have excess food available to them so they cannot get fat regardless of their main source of calories. Here in the US it is much easier to become overweight on a high carb diet than a high fat no simple carb diet because fats do not alter one's blood sugar levels nearly as much as carbs do.
MR166
5 / 5 (1) Apr 12, 2016
The real problem with crappy carbs is that they quickly raise blood sugar levels and thus become highly addictive. When your blood sugar drops you become VERY hungry and need another quick fix, a piece of chicken or some broccoli will just not satiate your hunger. Only more simple carbs will do. I know, I've been there.
rrrander
2.3 / 5 (3) Apr 14, 2016
Factor-in the ghetto thugs shooting 8000 of each other each year in the U.S. Most killed are in their 20's.
compose
Apr 14, 2016
This comment has been removed by a moderator.
kochevnik
1.5 / 5 (2) Apr 14, 2016
@MR166 "They will probably have lower quality food and not take supplements."

Don't be fooled and think that they eat lower quality food because they cannot afford better food. Many of the worst food products are also the most expensive. Baked goods, sugar products, cereals and snack foods are expensive killers.
Correct. Most ailments are caused by the body rotting from the inside. Rot manifests from relentless poisons accumulated in badly prepared foods. Plants have natural toxins and anti-nutrients which must be reduced by preparation, cooking and fermentation. Otherwise lectins will attack tissue causing inflammation diseases such as Alzheimers, heart disease and cancers

Most advanced disease is caused by bad practices and ignorance. In fact the poor are characterized by a core of people with knowhow and a periphery of those who chose to "flame out" instead of "fading away." The former produce the latter in ample quantities
eachus
5 / 5 (2) Apr 14, 2016
http://thehill.co...ce-1973.


Sigh! You have to know what the numbers mean. New jobless claims are people who were employed, and either quit or were fired/laid off. (Details: If you quit to take a better job, you can't file a jobless claim in the US for eight weeks, and certain ways of losing jobs don't count. Finally, in what is pretty crazy today, military jobs don't count, so leaving the Army, or whatever, does not increase jobless claims.)

You can have high unemployment and low jobless claims, like right now. Jobless claims reflect a change in employment status, the unemployment rate counts people who are looking for jobs and can't find them. ("Discouraged" workers are those who quit looking for jobs. If you go back to school in hopes that a better education will get you a job, you are a discouraged worker.)

Put it all together, and new claims has little relation to actual unemployment.
compose
Apr 14, 2016
This comment has been removed by a moderator.
Shootist
1.8 / 5 (5) Apr 15, 2016
Anyway, the unemployment rate, which is calculated from a different survey, fell to 4.9% from 5%, the Labor Department http://www.nytime...tml?_r=0


In the meantime 95 million American who were working in 2007 are still unemployed and will probably never work again. "Obama cares", my fat algore.
compose
Apr 15, 2016
This comment has been removed by a moderator.
EWH
3 / 5 (2) Apr 15, 2016
IQ is a fairly good predictor of wealth and independently of longevity. (Education corrected for IQ is not.) Heritability of adult IQ and longevity is higher than heritability of wealth. The most probable causal order is:
genes -> IQ, longevity, ;
IQ-> longevity, wealth
the hypothesis that wealth is a greater driver of longevity than genes is ruled out by the fact that both Hispanic men and Black women live longer than White men. (Adjusted for IQ or wealth the difference is even more striking.)
KBK
not rated yet Apr 16, 2016
Snipes and Harrelson, new film: "White Boys can't Live"
KBK
1 / 5 (1) Apr 16, 2016
Anyway, the unemployment rate, which is calculated from a different survey, fell to 4.9% from 5%, the Labor Department http://www.nytime...tml?_r=0


In the meantime 95 million American who were working in 2007 are still unemployed and will probably never work again. "Obama cares", my fat algore.


Yes, the data collection method is dishonest in the extreme.

IIRC, if one is out of work and looking,and on benefits and then off benefits, after a certain time, they are removed from the rolls--- job or not. So, they remain unemployed, they just stop pulling the published figures down.

NO OTHER country in the world does this bit of fakery, in their unemployment figures. Just the USA.

Many to most Americans are not aware of this bald faced chicanery. They need to be (made aware).

Unemployment figures in the USA are an incredible lie.
Eikka
not rated yet Apr 18, 2016
The real problem with crappy carbs is that they quickly raise blood sugar levels and thus become highly addictive.


To some, not to all. Millions and millions of people are quite happy subsisting on bread and pasta - the point is that they don't over-eat. The high or low GI of your food doesn't really matter if you're otherwise healthy with proper insulin response, because the body can maintain itself within normal levels of blood glucose regardless of the diet and you don't get the crash and bang hunger cycles.

The problems come when you develop bad habits like gorging yourself on pizza, over-eating huge meals, gulping a quart of soda per meal etc. and there's plenty of studies pointing out that our bodies are evolved to eat carbs and fats but not at the same time, becoming satisfied when we've reached a certain level of stimulus from them, which means that when both are available we tend to eat double.

You know, "there's always room for a dessert".
Eikka
not rated yet Apr 18, 2016
So there's just this unnecessary and unwarranted bashing of carbohydrates in people's diets, when the problem is really of over-indulgence. Part of the problem is the healthy diet recommendations that suggest you have to eat a bit of everything on every meal. That means you get a bit of fat and protein, a bit of carbohydrates, but since you're eating half and half you're not satisfied - you haven't reached your limit for either fats, proteins or carbs, so you eat more.

And when you consistently eat too much, you get the large up and down swings in blood sugar that eventually develops into diabetes because it stresses the whole insulin control system beyond its limits and eventually breaks it.

So as I understand it, it's far better to just eat bread when you're eating bread, or just eat meat when you're eating meat. Have a plate of cheese if you wish - as long as you aren't also stuffing your face with the crackers.
MR166
not rated yet Apr 18, 2016
"So as I understand it, it's far better to just eat bread when you're eating bread, or just eat meat when you're eating meat. Have a plate of cheese if you wish - as long as you aren't also stuffing your face with the crackers."

But that isn't the way we eat is it? The average US meal consists of animal fats and low grade carbs such as bread, pasta and rice.

I have never been less hungry than after I stopped eating low grade carbs. When I get hungry now it is about a 3 out of 10 in terms of urgency and can be totally disregarded if desired. When I ate a lot of simple carbs hunger became about an 8 out of ten and the need to eat became urgent.

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